Percutaneous Nephrolithotomy (PCNL) Opaleshoni

Percutaneous Nephrolithotomy (PCNL) ndi njira yopangira opaleshoni yomwe imagwiritsidwa ntchito kuchotsa miyala ikuluikulu ya impso. Zimaphatikizapo kupanga pang'ono kumbuyo ndikugwiritsa ntchito chubu chochepa kwambiri chotchedwa nephrroscope kuti alowe mu impso. Dokotala ndiye amathyola miyalayo pogwiritsa ntchito ultrasound kapena laser mphamvu ndikuchotsa zidutswazo kudzera mu chubu. Njirayi imalimbikitsidwa pamiyala yomwe imakhala yayikulu kwambiri kuti isadutse mwachilengedwe kapena yomwe imayambitsa kupweteka kwambiri. PCNL imasokoneza pang'ono, zomwe zimapangitsa kuti pakhale nthawi yochepa yochira komanso ngozi zochepa poyerekeza ndi opaleshoni yachizolowezi. Odwala ambiri amatha kupita kunyumba pakangopita masiku ochepa atachitidwa opaleshoni.
Omwe Ayenera Kuchita Percutaneous Nephrolithotomy (PCNL)
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Miyala Yaikulu ya Impso: Anthu okhala ndi miyala yokulirapo kuposa 2 centimita, yomwe imakhala yovuta kudutsa mwachilengedwe.
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Mavuto a Impso: Odwala omwe akumva kupweteka kwambiri, matenda, kapena kutsekeka chifukwa cha miyala ya impso.
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Zalephera Njira Zina: Omwe sanachite bwino ndi njira zocheperako, monga shock wave lithotripsy kapena ureteroscopy.
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Miyala Angapo: Anthu omwe ali ndi miyala yambiri yomwe imayenera kuchotsedwa nthawi imodzi.
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Thanzi Labwino Kwambiri: Otsatira ayenera kukhala ndi thanzi labwino kuti achitidwe opaleshoni ndi opaleshoni.
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Malingaliro a Anatomical: Omwe ali ndi mawonekedwe abwino a impso omwe amalola kuti azitha kugwiritsa ntchito njirayi.
About Percutaneous Nephrolithotomy (PCNL)
Percutaneous nephrolithotomy (PCNL), njira yabwino kwambiri ya miyala ikuluikulu ndi / kapena yovuta, ndiyo njira yabwino kwambiri yogwiritsira ntchito miyala ya impso. Panthawiyi, katswiri wa urologist amapanga 12-inch incision kumbuyo kwanu ndikuyika chubu chopanda kanthu kuti alowe m'dera lomwe muli miyala ya impso mkati mwa impso yanu. Miyalayo imatengedwa yathunthu kapena kugawanika kukhala zidutswa ndi kuchotsedwa pogwiritsa ntchito telesikopu yolimba yachitsulo.
PCNL ili ndi chiwopsezo chachikulu chochotsa miyala yayikulu ya impso ndi zovuta zochepa. Komabe, monga njira iliyonse ya opaleshoni, pali zoopsa zina, monga kutuluka magazi, matenda, ndi kuwonongeka kwa ziwalo zozungulira.
Kuopsa ndi Ubwino wa Percutaneous Nephrolithotomy (PCNL)
Ubwino wa Percutaneous Nephrolithotomy:
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Kuchotsa Mwala Mwaluso: PCNL ndi yothandiza kwambiri pochotsa miyala ikuluikulu ya impso, makamaka yomwe sichitha kuthandizidwa ndi njira zina. Ikhoza kuchotsa miyala mu impso bwino, kuthandiza kuthetsa ululu ndi kupewa zovuta zina.
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Osasokoneza pang'ono: Njirayi ndi yovuta kwambiri poyerekeza ndi opaleshoni yamba. Zimangofunika kudulidwa pang'ono kumbuyo, zomwe zimapangitsa kuti minofu iwonongeke komanso kuchira msanga.
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Chipatala Chachifupi: Odwala ambiri amatha kupita kunyumba pakangopita masiku ochepa atachitidwa opaleshoni, nthawi zambiri mkati mwa masiku 1 mpaka 3, poyerekeza ndi kukhala nthawi yayitali kuti achite maopaleshoni obwera.
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Kuchepetsa Nthawi Yochira: Odwala ambiri amatha kubwerera kuntchito zawo zachizolowezi, kuphatikizapo ntchito, mkati mwa sabata imodzi mpaka 1, malingana ndi thanzi lawo lonse ndi kuchira kwawo.
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Chiwopsezo Chochepa cha Zovuta: Akachitidwa ndi madokotala odziwa bwino opaleshoni, PCNL nthawi zambiri imakhala ndi chiopsezo chochepa cha zovuta poyerekeza ndi opaleshoni yotsegula.
Zowopsa za Percutaneous Nephrolithotomy:
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Kusuta: Pali chiopsezo chotaya magazi mkati kapena pambuyo pa opaleshoni. Nthawi zina, kuikidwa magazi kungafunike.
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Kutenga: Mofanana ndi opaleshoni iliyonse, pali kuthekera kwa matenda pamalo ocheka kapena mkati mwa impso. Mankhwala opha tizilombo nthawi zambiri amaperekedwa kuti ateteze izi.
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Kuvulala kwa Ziwalo Zozungulira: Pali chiopsezo chochepa chowononga ziwalo zoyandikana nazo, monga mapapu, matumbo, kapena mitsempha ya magazi panthawi ya ndondomekoyi.
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Fluid Leakage: Nthawi zina, mkodzo ukhoza kutuluka m'thupi ngati impso yawonongeka panthawi ya ndondomekoyi, yomwe ingafunike chithandizo chowonjezera.
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Kufunika Kuchita Maopaleshoni Ena: Nthawi zina, si miyala yonse yomwe ingachotsedwe mwa njira imodzi, zomwe zimapangitsa kuti pakufunika chithandizo chowonjezera.
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Ululu Pambuyo-Operative: Odwala amatha kumva kupweteka kapena kupweteka pambuyo pa opaleshoni, yomwe nthawi zambiri imatha kuthandizidwa ndi mankhwala.
Njira ya Percutaneous Nephrolithotomy (PCNL)
Percutaneous nephrolithotomy (PCNL) ndi opaleshoni yopangidwa kuchotsa miyala ikuluikulu ya impso. Nayi tsatanetsatane wa ndondomekoyi m'chinenero chosavuta:
Pamaso pa Ndondomeko ya Zamgululi:
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Kufunsa: Wodwalayo amakumana ndi urologist (dotolo yemwe amagwira ntchito za mkodzo) kuti akambirane mbiri yawo yachipatala ndi mankhwala aliwonse am'mbuyomu a miyala ya impso.
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Mayeso a Preoperative: Dokotala akhoza kuyitanitsa mayeso a magazi, kuyesa mkodzo, ndi maphunziro a zithunzi (monga ultrasound kapena CT scan) kuti atsimikizire kukula ndi malo a miyala ya impso.
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Kukonzekera: Nthawi zambiri odwala amalangizidwa kuti asamadye kapena kumwa kwa maola angapo opaleshoni isanayambe. Kukonzekera kuti wina aziwayendetsa galimoto pambuyo pake kumalimbikitsidwanso.
Panthawi ya Ndondomeko ya Zamgululi:
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Anesthesia: Wodwala amapatsidwa mankhwala oletsa ululu, zomwe zikutanthauza kuti adzakhala akugona komanso opanda ululu panthawi ya opaleshoni. Nthawi zina, anesthesia ya m'dera ingagwiritsidwe ntchito kuti dzanzi m'munsi thupi.
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Positioning: Wodwalayo ali pamimba pawo kapena pambali pa tebulo la opaleshoni, kuti azitha kupeza mosavuta impso.
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Kuperewera: Dokotala wa opaleshoni amacheka pang’ono (pafupifupi 1 cm) pakhungu kumunsi kwa msana, nthawi zambiri kumunsi kwa nthiti. Kudulidwa kumeneku kumapangitsa kuti munthu apite ku impso.
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Kupanga Tunnel: Dokotala amagwiritsa ntchito singano yapadera kupanga ngalande kuchokera pakhungu kupita ku impso. Singanoyo ikalowa m'malo mwake, amalowetsa waya wolondolera, ndipo chubu chachikulu chotchedwa dilator chimagwiritsidwa ntchito kukulitsa ngalandeyo.
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Kuyika Nephroscope: Nephroscope (chubu yopyapyala, yosinthasintha yokhala ndi kamera) imalowetsedwa kudzera mu dilator kulowa mu impso. Zimenezi zimathandiza kuti dokotala wa opaleshoniyo aziona miyalayo bwinobwino pa monitor.
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Kuphwanya Miyala: Dokotala amagwiritsa ntchito zida zapadera, monga lasers kapena ultrasound, kuti athyole miyala ya impso kukhala zidutswa zing'onozing'ono. Zidutswazo zimachotsedwa kudzera pa nephrroscope.
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Kuyika Stent: Nthawi zina, stent (chubu chopyapyala) chikhoza kuikidwa mu ureter (chubu cholumikiza impso ndi chikhodzodzo) kuti chithandizire kukhetsa mkodzo ndikulola kuchira.
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Kutseka Kwacho: Miyalayo ikachotsedwa, dokotalayo amachotsa nephrroscope ndi kutseka chodulidwacho ndi stitches kapena staples. Bandeji imayikidwa pamalo ocheka.
Pambuyo pa Ndondomeko ya Zamgululi:
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kuchira: Wodwala amasamutsidwira kumalo ochiritsira kumene amayang'aniridwa pamene akudzuka kuchokera ku anesthesia. Manesi adzayang'ana zizindikiro zofunika ndikuwongolera kusapeza kulikonse ndi mankhwala opweteka.
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Kukhala Pachipatala: Odwala ambiri amakhala m'chipatala kwa masiku 1 mpaka 3, malingana ndi momwe alili komanso momwe akuchira. Ena angapite kunyumba tsiku lomwelo ngati ali okhazikika.
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Tsatirani Chisamaliro: Dokotala adzapereka malangizo amomwe angasamalire chodulidwacho, kusamalira ululu uliwonse, ndi zomwe muyenera kupewa mukachira. Nthawi yotsatila nthawi zambiri imakonzedwa kuti ayang'ane machiritso ndi kuchotsa zomangira zilizonse ngati kuli kofunikira.
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Malangizo Pambuyo Opaleshoni: Odwala amalangizidwa kuti amwe madzi ambiri kuti athandize kuchotsa zidutswa za miyala zomwe zatsala ndipo akhoza kupatsidwa mankhwala oletsa matenda.